Gilbert G L, Clements D A, Broughton S J
Department of Microbiology and Infectious Diseases, Royal Children's Hospital, Parkville, Victoria, Australia.
Pediatr Infect Dis J. 1990 Apr;9(4):252-7. doi: 10.1097/00006454-199004000-00006.
Invasive Haemophilus influenzae type b (HIB) infections occurring from 1985 to 1987 in children younger than 16 years of age living in the state of Victoria were reviewed. There were 547 cases which fulfilled the case definition, including 231 cases of meningitis, 219 of epiglottitis and 97 other infections; 14 (2.6%) children died, 8 with meningitis, 5 with epiglottitis and 1 with pneumonia. Ninety-five percent of cases occurred in children younger than 5 years of age, in whom the case attack rate was 58.5/100,000/annum. Nearly two-thirds of cases (46% of meningitis; 91% of epiglottitis; 45% of other infections) occurred in children more than 18 months of age (the age at which vaccine is presently given in the United States). Compared with the United States, the case attack rate for HIB disease in Victoria is lower, the mean age of affected children higher and the proportion with epiglottitis is greater. However, the incidence, age distribution and clinical manifestations of HIB disease in Victoria are similar to those described in Scandinavia before the successful introduction of vaccines. Effective conjugate vaccines against HIB disease are now available and the majority of cases are preventable (depending on the immunization schedule used). These data suggest that immunization of Victorian children against HIB infection should be cost-effective.
对1985年至1987年期间居住在维多利亚州16岁以下儿童中发生的侵袭性b型流感嗜血杆菌（HIB）感染进行了回顾。有547例符合病例定义，包括231例脑膜炎、219例会厌炎和97例其他感染；14名（2.6%）儿童死亡，8名死于脑膜炎，5名死于会厌炎，1名死于肺炎。95%的病例发生在5岁以下儿童中，其年发病率为58.5/100,000。近三分之二的病例（脑膜炎病例的46%；会厌炎病例的91%；其他感染病例的45%）发生在18个月以上的儿童中（美国目前接种疫苗的年龄）。与美国相比，维多利亚州HIB疾病的发病率较低，受影响儿童的平均年龄较高，会厌炎患者的比例较大。然而，维多利亚州HIB疾病的发病率、年龄分布和临床表现与疫苗成功引入之前斯堪的纳维亚半岛所描述的情况相似。现在已有针对HIB疾病的有效结合疫苗，大多数病例是可以预防的（取决于所采用的免疫接种计划）。这些数据表明，对维多利亚州儿童进行HIB感染免疫接种应具有成本效益。
